血管性痴呆患者血清尿酸及胆红素水平与认知功能损伤之间的关系

目的评价血管性痴呆患者血清尿酸及胆红素水平与认知功能损伤之间的关系。方法选取2015-01—2018-12在郑州大学第五附属医院神经内科住院治疗的血管性痴呆患者197例,同时,选取95名健康老年人作为对照组,收集2组患者一般资料,对2组患者肝功能、肾功能及血脂水平进行检测,利用量表对2组患者神经心理功能进行测验,比较2组患者血清尿酸和胆红素水平的变化,并研究其与神经心理功能评分的相关性。结果血管性痴呆组患者简易智力状态检查量表(MMSE评分)、剑桥老年认知检查表-中国修订版(CAMCOG-C)评分和画钟试验(CDT)评分均低于对照组,而日常生活能力(ADL)和临床痴呆评定量表(CDR)评分均高于对照组,差异均具有统计学意义(P<0.05);血管性痴呆组患者血清总胆红素、直接胆红素和间接胆红素水平均低于对照组,而尿酸水平高于对照组,差异均具有统计学意义(P<0.05);Pearson相关分析显示,血清尿酸水平与MMSE评分、CAMCOG-C评分和CDT评分均呈负相关(r=-0.217,-0.196和-0.264,均P<0.05),而与ADL评分呈正相关(r=0.302,P<0.05),总胆红素水平与CAMCOG-C评分和CDT评分均呈负相关(r=-0.167和-0.205,均P<0.05),与ADL评分呈正相关(r=0.215,P<0.05);Logistic回归分析显示,MMSE评分与患者教育年限、高血压史及尿酸水平相关(P<0.05)。结论血管性痴呆患者血清尿酸水平升高,且与患者认知功能评分呈负相关,而与患者日常生活能力评分呈正相关;总胆红素水平降低,且与患者认知功能评分呈负相关,而与日常患者生活能力评分呈正相关。高尿酸水平可能与血管性痴呆的发生有关,为血管性痴呆发生的独立危险因素之一。

Correlation between levels of serum uric acid,bilirubin in patients with vascular dementia and their cognitive impairment

Objective To investigate the relationship between serum levels of uric acid and bilirubin,and cognitive function in patients with vascular dementia.Methods 197 cases of patients with vascular dementia enrolled in the Department of Neurology of the Fifth Affiliated Hospital of Zhengzhou University were selected from January of 2015 to December of 2018.At the same time,95 cases of healthy elderly were chose as the control group.The general information of the two groups was collected.Liver function,renal function and lipid levels were detected in patients of the two groups.The neuropsychological functions of patients in the two groups were tested by scales.The serum uric acid and bilirubin levels were compared between the two groups.And the relationship between serum levels of uric acid and bilirubin,and cognitive function was also analysed.Results The MMSE score,CAMCOG C score and CDT score in vascular dementia group were lower than the control group,while,the ADL score and CDR score were higher,the differences were statistically significant(P<0.05).The levels of total bilirubin,direct bilirubin and indirect bilirubin in vascular dementia group were lower than the control group,while,the uric acid level was higher,the differences were statistically significant(P<0.05).Pearson correlation analysis showed serum uric acid levels were negatively correlated with MMSE score,CAMCOG C score and CDT scores(r=-0.217,-0.196 and-0.264,all P<0.05),but serum uric acid levels were positively correlated the the ADL scores(r=0.302,P<0.05).The total bilirubin levels and CAMCOG C score and CDT scores were negatively correlated(r=0.167 and 0.205,all P<0.05),and ADL scores were positively correlated(r=-0.215,P<0.05).Logistic regression analysis showed,MMSE score were associated with education years,hypertension and uric acid levels(P<0.05).Conclusion The levels of uric acid in vascular dementia patients were elevated,and negatively correlated with cognitive function scores,while positively correlated with daily living scores.The levels of total bilirubin were reduced,and negatively correlated with cognitive function scores,while positively correlated with daily living scores.Increased levels of uric acid may be one of the risk factor of vascular dementia.